The pH and Titratable Acidity of Intravenous Infusion Solutions

Abstract

<jats:p> The acidic nature of infusion solutions may contribute to local thrombophlebitis or systemic acidosis. The pH of four commercially available solutions ranged from 4·55 to 6·40 and titratable acidities (to pH 7·4) ranged from 0·18 to 1·08 meq acid/litre. When equilibrated in vitro at PCO<jats:sub>2</jats:sub> of 40 mm Hg the pH ranged from 4·5 to 6·0 and titratable acidity ranged from 20 to 26 meq acid/litre. Two solutions prepared from commercial solutions and containing 28 meq/litre sodium bicarbonate had a pH of 7·5 and a titratable acidity of 4–5 meq base/litre when equilibrated at a PCO<jats:sub>2</jats:sub> of 40 mm Hg. Systemic acidosis due to some infusions may be prevented by the addition of sodium bicarbonate to the infusion solutions to produce a pH of 7·4 at PCO<jats:sub>2</jats:sub> of 40 mm Hg. </jats:p>

Role of acidic pH of intravenous fluids in subsequent development of metabolic acidosis- may not be what it seems

“…D5, NS) varied between 0.063 to 9.480 meq acid/l, depending on the method used for preparation and sterilization. [14] Gaudry et al . also mention that though many have measured the pH of common IVFs, not much data are available regarding their titratable acidity.…”

“…also mention that though many have measured the pH of common IVFs, not much data are available regarding their titratable acidity. [4] The work of Gaudry et al . dates back to 1972 and a PubMed search by us with the term ‘titratable acidity fluid/titratable acidity solution/titratable acidity infusion’ revealed only two studies relevant to this discussion.…”

“…[35] Though the in vitro pH of D5 and NS is acidic, their effect on H+ balance is probably negligible. [24] It may be because of their low titratable acid content. [4] But metabolic acidosis accompanies infusion of these solutions.…”

“…[24] It may be because of their low titratable acid content. [4] But metabolic acidosis accompanies infusion of these solutions. [12467] This acidosis was explained by dilution of bicarbonate content in plasma.…”

“…[4] But metabolic acidosis accompanies infusion of these solutions. [12467] This acidosis was explained by dilution of bicarbonate content in plasma. [267] Subsequently Stewart's physiochemical approach was used to describe the in vivo effect on acid base status by IVFs.…”